Correvon Nils, Fasquel Lucas, Yazdani Pouyan, Michotte Jean-Bernard, Dugernier Jonathan, Contal Olivier
School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.
Physiotherapy Unit, Réseau Hospitalier Neuchâtelois (RHNe), Pourtalès Hospital, Neuchâtel, Switzerland.
Front Med Technol. 2022 Jul 27;4:891390. doi: 10.3389/fmedt.2022.891390. eCollection 2022.
CPAP is the first line treatment of obstructive sleep apnea. Recently, the use of added filters has been debated following the field safety notice of Philips Respironics™ on potential health risks due to foam degradation used in their ventilators. However, the added resistance of filters has never been analyzed.
The primary aim was to investigate the impact of four different filters on APAP mode performance with and without added unintentional air leaks (UIAL) with two simulated respiratory events. The secondary aim was to assess the pressure drop due to the increased filter resistance at different fixed CPAP pressure levels.
This is a bench study. Performance tests were performed on a breathing simulator (ASL 5000™) with a DreamStation™ device. To assess the combined effect of UIAL, a controlled valve was added to the setup.
Without UIAL, the algorithm was able to detect respiratory events and increase pressure level consequently. In the presence of UIAL, the device's response to simulated events was affected. In fixed CPAP mode, the median measured end-expiratory pressure was 6.2 to 10.0% ( < 0.001) below the set pressure with the additional filters. Additional UIAL severely impacted the delivered pressure with a median reduction up to 28.3% ( < 0.001) to the set pressure.
Despite a slight pressure drop, the APAP algorithm still performed with additional filters when UIAL were avoided. However, the combined effect of added filter resistance and UIAL severely impacted APAP performance and effectively delivered set pressure.
持续气道正压通气（CPAP）是阻塞性睡眠呼吸暂停的一线治疗方法。最近，在飞利浦伟康公司（Philips Respironics™）发布关于其呼吸机中使用的泡沫降解可能带来健康风险的现场安全通知后，附加过滤器的使用引发了争议。然而，过滤器增加的阻力从未被分析过。
主要目的是研究四种不同过滤器在有无附加无意空气泄漏（UIAL）以及两种模拟呼吸事件情况下对自动调压型持续气道正压通气（APAP）模式性能的影响。次要目的是评估在不同固定CPAP压力水平下由于过滤器阻力增加导致的压力降。
这是一项实验台研究。在带有DreamStation™设备的呼吸模拟器（ASL 5000™）上进行性能测试。为了评估UIAL的综合影响，在装置中添加了一个控制阀。
在没有UIAL的情况下，算法能够检测到呼吸事件并相应提高压力水平。在存在UIAL的情况下，设备对模拟事件的反应受到影响。在固定CPAP模式下，使用附加过滤器时，测得的呼气末压力中位数比设定压力低6.2%至10.0%（<0.001）。额外的UIAL严重影响了输送压力，中位数降低幅度高达设定压力的28.3%（<0.001）。
尽管有轻微的压力降，但在避免UIAL时，APAP算法在使用附加过滤器的情况下仍能运行。然而，附加过滤器阻力和UIAL的综合影响严重影响了APAP性能以及有效输送的设定压力。
